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Individual

KIMBERLY BLACKHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D., LMFT

Contact information

Practice address
1 WEST BROAD STREET, 11TH FLOOR, BETHLEHEM, PA 18018-1801
(336) 749-6596
Mailing address
4502 HOMESTEAD DR, NAZARETH, PA 18064-8996
(336) 749-6596

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MF000920
PA

Other

Enumeration date
07/26/2017
Last updated
07/26/2017
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